Collier County, FL; The battle is on

[sirduke]

Grow up little firemonkey.

We are fortunate to have our own stations, and NON FIRE based EMS here. If you hate EMS so, then take your little troll self off to a fire forum.

Saying firefighters are the only professionals, and that the rest of public service are not is a typical blanket statement made by insecure firefighters who see that their "profession" is becoming extinct.

You sir are a troll, go find your bridge.

[jbanagas]

Grow up little firemonkey.

We are fortunate to have our own stations, and NON FIRE based EMS here. If you hate EMS so, then take your little troll self off to a fire forum.

Saying firefighters are the only professionals, and that the rest of public service are not is a typical blanket statement made by insecure firefighters who see that their "profession" is becoming extinct.

You sir are a troll, go find your bridge.

, I disagree, we have bigger and better unions and with more EMS/rescue responsibilities I doubt our role will be extinct any time soon. Police officers are just as professional in there service as well, so your right Fire/base ems is not the ONLY professional service.

[ERDoc]

We seemed to have picked up a few trolls this week. It think the best way to handle them would be to just ignore them, reguardless of how hard they try. Ignore them enough and they will go away. The rest of us can just continue on with our normal, professional level of discussion.

[VentMedic]

http://www.nbc-2.com/articles/readarticle....d=22889&z=3

Collier County EMS Q & A

Originally posted on: Friday, November 07, 2008 by NBC2 News

Last updated on: 11/7/2008 4:28:42 PM

Q & A with Collier County EMS over aborted emergency call

Answers to questions from NBC2 Investigator Kara Kenney

What is Collier EMS's version of the events? Why did you stop the call?

On September 04th, Dr. Tober requested all fire departments to provide records to assure Collier County’s compliance with Sections 401.265 F.S. & 401.281, F.S. A deadline was established for October 1st, however the City of Naples requested an extension. It was extended by 15 days.

By 4:00pm, on October 15th, the City of Naples still had not provided all of the necessary information. More alarming was the fact that a spreadsheet (attached) provided by City of Naples Fire Training Officer, Battalion Chief Torrella, shows that only 4 of their 33 firefighters comply with the State’s minimal driver’s training requirements (16 hours). (Florida Chapter 64E(J)-2,.012, (2)). Surprisingly, there was also a notation on the bottom of Torrella’s spreadsheet stating “Those members lacking the certification (EVOC) will be instructed within the next 45 days”. Obviously, I had an immediate concern that the City of Naples may be having problems maintaining their driving standards similar to their struggles with medical certification. Immediately, between the hours of 4:30 – 5:00pm, I called BC Torrella and left a message expecting a call-back. I was hoping that he could confirm this was just another clerical omission, and we could settle the issue over the phone and move on.

Around 7:30am of the following morning, I had not heard from Torrella and called again. No answer. I then attempted to contact Chief McEvoy on his cell phone but was forced to leave a message. I called his secretary who informed me he was in a meeting at City Hall. At this point I had exhausted my only regular points of contact and chose to contact our Battalion Chief Bill Peplinski to find out who was scheduled to work on the ambulance. I was informed that Firefighter Kofsky was scheduled, who is somebody I do not know and was listed as ineligible to drive an ambulance. After a short discussion of our options, I instructed BC Peplinski to place himself out-of-service, drive down to their station and replace Kofsky until we could either remedy the situation or find another replacement. I also authorized overtime to be expended by our department so we could back-fill the City of Naples’ employee. I understood the choice to use overtime was outside my normal scope of authority, however we were attempting to exercise any/all options to find a remedy to the City of Naples’ dilemma.

Throughout all of this confusion and despite the fact the crew on EMS Medic Rescue 2 was told that Kofsky could not drive the ambulance, he did it anyhow. Being that no direction was given to place the unit out-of-service, a call was dispatched for an incident at an assisted care facility. Both EMS Medic Rescue 02 and City of Naples Rescue 02 responded from the same station. During the response, BC Peplinski called Medic Rescue 02 and asked if Kofsky was driving, he was told “yes” because they thought the matter was remedied. BC Peplinski explained otherwise and instructed them to have another unit handle the transport and they would be placed out-of-service. Even though the crew was almost to the scene, they interpreted the order as they could not finish the drive to the call, but instead the crew chose to drive back to the station.

Despite the claims within the City of Naples’ memo, proper certification was never confirmed for Kofsky. Actually, over the next hour, I juggled several other phone calls between Chief McEvoy’s secretary, and Naples Battalion Chief Matt Reed. By 9:45am, BC Reed assured me that Kofsky had the proper certification and claimed Torrella’s list was erroneous. I explained to Matt that while I trusted him, it would be in our best interest if he could provide either a copy of Kofsky’s EVOC certification, or an updated list that corrected the mistakes within their original document. Around 30 minutes later, I was informed neither could be provided and the City of Naples would rather replace Kofsky with another firefighter, Steven Garrity. They immediately faxed a copy of Garrity’s certification and to my knowledge, Kofsky was never placed back onto the ambulance.

Throughout the day, it was apparent that Matt Reed was working diligently to provide the proper documentation necessary for State compliance. He called me several times, however by 3:00pm, they were unable to produce certificates or compile an updated list that assured the appropriate driving hours/curriculum was ever taught. At 3:37pm, I received a memo from Chief McEvoy that explained they still needed more time to finalize a “forthcoming” report. Once again, I spoke to Reed who offered his personal assurance that anyone placed onto the apparatus would only be selected based on the fact they had queried/confirmed their training information. Not until the following week did we receive their report and copies were placed into all of their employee’s files.

It is worth mentioning that as of this date, there is still information that has yet to be provided by the City of Naples. According to the Records Custodian;

None of their firefighter’s drivers licenses have been provided

Two have not provided either an EMT or Paramedic license

One employee’s BLS certification is expiring this month

3-What was the condition of the 92 year old woman? (

The patient was stable on the arrival of the EMS unit. Although the initial O2 sat was 88, the rest of her vital signs were excellent = pulse rate of 64, respiratory rate of 18 and blood pressure 120/80. An O2 sat of 88 accompanied by these vital signs is not indicative of an emergency. For example, long time smokers routinely have lower readings than 88 and readings can also be altered by poor circulation in the extremities such as can be caused by a patient being cold or by finger nail discolorations, either yellowing and thickening which can happen in the aged or with nail polish. The rest of the vitals are not alarming, particularly for an older patient. Once oxygen was in place, her O2 sat went to 96%.

Any estimate as to how much longer this woman had to wait for care and/or a transport based on this mixup? [WatsonWayne] There was no delay in care. Rescue 02 was on scene, and provided all of the care ever rendered to the patient. No addition treatment was necessary when the ambulance arrived. An EKG was applied, however no other medications or care was needed beyond the capabilities of Rescue 02. Being that the City of Naples did not complete an official Patient Care Report (another violation being investigated) the best I can discern is that it took 8 minutes from the time the City arrived on-scene until the ambulance arrive to provide transport.

Did Kofsky have a valid EVOC certification or not?

It was not provided until the following week. Actually, as written above, the City of Naples chose to replace him with other firefighter.

Have there been problems with firefighters not having their certifications? What are the issues?

We were again facing the possibility of having to self report to the State each transport violation where an unqualified crew member was on board a licensed transport unit.

What do you say to NFD firefighter 's allegation that the political turmoil is "endangering citizens" and negatively impacting emergency care?

As proven, this issue, while unfortunate and unnecessary, did not endanger the patient. Defining the County and City of Naples' attempts to police administrative discrepancies as "political turmoil", including the potential insubordination of a crew who was advised to not allow Firefighter Kofsky to drive an ambulance is a misrepresentation of the facts.

There are no cases where revisions to protocols or any other administrative issues have negatively impacted a patient. The Medical Director has explained in several forums that clinical evidence supports the concept of good Basic Life Support saving more lives than Advanced Life Support. He is simply acting prudently in monitoring the licensure of persons operating under his medical license and stressing need based training and medical care.

Another article:

http://www.nbc-2.com/articles/readarticle.asp?articleid=22890&z=3

[Doczilla]

Het man don't hate just beacause we got it made in southern cali, it is what it is, man we ain't Dr's so all the protocols in world don't make a difference if the er is is two mins away. Pt. care is treating the pt nice and respectful, not performing the lates medical procedure.

Did someone hang out an EMT City sign at the local poser and wannabe union? Where are we getting these dumbasses lately?

Or is Dustdevil laughing his ass off at this epic joke that he's playing on us?

'zilla

[reaper]

Did someone hang out an EMT City sign at the local poser and wannabe union? Where are we getting these dumbasses lately?

Or is Dustdevil laughing his ass off at this epic joke that he's playing on us?

'zilla

That very thought crossed my mind too!

[ERDoc]

I thought about someone on here playing a joke, but Dust, I just can't see it. I tried to picture him posting some of these things but it always ended with his head exploding just before he hit "Submit".

I think I'll add it to this thread too:

[Dustdevil]

I thought about someone on here playing a joke, but Dust, I just can't see it. I tried to picture him posting some of these things but it always ended with his head exploding just before he hit "Submit".

Yeah... I just couldn't bring myself to do such a thing.

[Richard B the EMT]

I'll keep mentioning that the NYC EMS was an existing hospital based service, under the New York City Health and Hospitals Corporation. Then Mayor Rudy Guiliani gave a payback to the FDNY unions for votes electing him as Mayor (that last is my opinion), by starting the city council and the New York State Legislature to change the law so that the EMS would be severed from the HHC, and put under the management of the FDNY.

This was not of my doing, as I voted for Rudy's opponent, nor of my desire, personally or via my union.

Those in FDNY EMS are mission specific EMTs and Paramedics working EMS, while the Fire Fighters get a bit extra pay for each time they respond to a medical call as Certified First Responders-Defibrillation, but otherwise are mission specific.

EMS may be fire service based, but we "posted" (staged) at that gas station from before the "merger".

I again mention that EMTs and Paramedics working for FDNY EMS who might be Fire Fighters in their home communities are not allowed to use their Fire Fighter skills in the FDNY. Also, Fire Fighters who might be EMTs of Paramedics in their home communities are not allowed to use their EMT or Paramedical skills in the FDNY. Everyone seems to be "Mission Specific", as I wrote before.